Comparative Study BetweenTransepithelium and Epithelium off Corneal Collagen Cross Linking In Ectatic Corneal ConditionsAhmed YosryMostafa
AbstractCornealcollagen cross-linkinghas been used as a treatmentoption in patients with either keratoconus or iatrogeniccorneal ectasia after LASIK. The purpose of cornealcross-linking is to stabilize the corneal stroma and to delaythe progression of these 2 pathologic entities. Studies onhumans with keratoconus have demonstrated satisfactoryshort-term and long-term results with significant topographicand refractive improvement following treatment. In our study we aimed at evaluating the efficacy of CXL in stabilizing ectatic corneas and the augmentation of its results with and without removing the epithelium. Our study included 30 eyes of 24 patients all underwent CXL between May 2015 and March 2016. All patients were evaluated preoperatively for their UCVA, BCVA, K readings, degree of corneal astigmatism and pachymetry (using Pentacam), and corneal biomechanical properties (using ORA). Eyes later were subdivided into two groups, Group 1 was the CXL (epithelium-off) group where CXL was done after removing the epithelium. Group 2 was the CXL (transepithelium) group where we performedwith the epithelium intact. All patients after 6 months had a significant improvement in their UCVA, BCVA, cylinderical refraction, corneal astigmatism, maximal K value and IVA with minimal non-significant changes in their pachymetry. CH and CRF revealed non-significant improvement in 85% of patients though a positive relation was encountered with the improvement in maximal K value. Patients in groups 1, 2 showed no significant differences in their BSCVA achieved by the end of the year. Group 1 and 2 patients when compared also revealed no statistical difference in their topographic or biomechanical changes by the end of the study. Patients who underwent epithelium removal and CXL showed significantly more improvement in refractive astigmatism than group 2 which can be explained by the better corneal symmetry achieved in these patients as revealed by the IVA results. No serious or permanent complications were encountered in all patients included in our study. We recommend CXL as a successful, safe and inexpensive procedure for patients with corneal ectasia that helps to delay if not prevent the need for corneal transplantation later on and to achieve a good visual quality for these patients specially when combined with other procedures.
|Other Titles||دراسة تباينية في علاج حالات بروز القرنية باستخدام تشابك روابط الكولاجين من خلال وجود الخلايا الطلائيه السطحيه أو عند ازالتها||Issue Date||2016||URI||http://research.asu.edu.eg/handle/12345678/2696|
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